Conjeevaram, Srinivasulu

Conjeevaram, Srinivasulu is an individual health care provider with primary practice located at 100 Linwood Ave Ste 2A , Colchester CT 06415-1138. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Conjeevaram, Srinivasulu can be contacted via phone (860) 415-3622.

Contact Information

Primary practice address
100 Linwood Ave Ste 2A Colchester CT 06415-1138
Phone: (860) 415-3622
Fax: (860) 974-0884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 53644 Connecticut
Allopathic & Osteopathic Physicians / General Practice 208D00000X 4301086842 Michigan
Allopathic & Osteopathic Physicians / General Practice 208D00000X 53644 Connecticut
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 53644 Connecticut

Profile Details

NPI number 1780958058
LBN Legal business name Conjeevaram, Srinivasulu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2012
Last updated Mar 24th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780958058 NPPES
Connecticut Other 053644 STATE MEDICAL LICENSE

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